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Need help, very confused and worried (BLOODWORK)

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16
For over 2 months now I've been experiencing a few neurological symptoms.

The first and most notable of these is full body tremors. These occur upon action and also posturally, never at rest. The place most effected is my hands and notably thumbs and index fingers. However, I've felt some degree in my legs, abs, shoulders, feet, even face and neck. Most of the time they're pretty minor but certain things like physical activity and anxiety make them more prominent.

On top of this I've also had muscle twitches. These have been periodic and don't occur everyday. They are generalized (happen all over) and not super frequent but nonetheless annoying. I've also had transient numbness and tingling. Nothing too severe and don't last long, but enough to notice certainly in my limbs seemingly randomly most of the time.

I've experienced a few other symptoms like breathlessness and fast HR but unsure if this is due to whats happening or my anxiety about it.


Anyways, I got back my bloodwork after seeing a neurologist. There are a few things I am notably confused and worried about.


First being I have an elevated aldolase level of 12.9. CK is in the high normal range at 204. I have heard this can be brought on by strenuous exercise and am praying this is the case. I lift 5-6x per week (and did probably 12-13 hours before the bloodwork) very heavy. I'm somewhat of a bodybuilder and have well above average muscle mass. I have NOT noticed any weakness so I'm hoping this indicates I am not expriencing some of kind of muscular disease. Nonetheless this is freaking me out a bit. I may take a short break from working out and have these levels retested. CK was in range as mentioned albeit high normal and so were AST and ALT (both high normal).


My second concern is low iron and ferritin. My iron is 55 on a scale of 50-212 and ferritin 19 on a scale of 24-336. I have NO clue what could cause this. I eat a lot of meat in my diet so I'd think I would have adequate iron. I'm guessing possibly an absorption issue. I also had low normal vitamin d3 of 35 and had been supplementing 5000 iu everyday up to a week before the test. Any reason for the low levels of these? My best guess is absorption issues. I have cut out all gluten of my diet to see if that resolves it. I am also supplementing iron everday. How much is safe to take. Right now I'm taking 4 pills a day at 167% DV each. Could these levels explain any of my symptoms?


My third question/concern is that my b12 is high and mma is very low with normal homocysteine. My b6 and zinc are also slightly high. The b12 is not surprising as I had briefly supplemented high doses for 3 weeks thinking I had a defiency. I stopped 2 weeks before the test, but I'm guessing they're still elevated from that. Does high b12 with low MMA and normal homocysteine rule out a b12 deficiency? I'm curious, cause b12 has seemed to make me feel slightly better but only periodically. I actually have some injections on the way I'm gonna try since I suppose it can't hurt but it seems I don't have a deficiency or functional deficiency of any sort to my knowledge.

In terms of the b6 elevation, I was taking approximately 50 mg b6 synthetic and 20 mg p5p prior to the blood testing stopping 1 week before. It was only slightly above range. It seems a little low of a dose to have out of range b6 though and I had stopped a whole week prior. Is functional deficiency ruled out for this as well? I have stopped all b6 supplementation except in a multivitamin I take half a dose of giving me 5 mg p5p.


I also had an ANA test that came back negative and one other notable think I saw was that my protein levels were barely in range at 6.4 on a scale of 6.4-8.9. I don't know the indication of this. Once again, I've had no weakness (train regularly and still lifting same weights) or muscle loss. Could the abnormalities in this and the aldolase just be from working out with heavy weights frequently? My dr seems clueless


Here are the full bloodwork results:







 
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16
sorry fo the poor pictures. I can retake or just post values if anyone has trouble reading them. I really need help here guys. I have no idea what's going on and am freaking out a bit.
 
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16
I have another question. Could the low iron plus strenuous workouts be why I have excessive muscle damage (aka not recovering properly)? Also what would high aldolase but within range CK indicate as I believe CK is a marker for muscle damage as well.
 
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Hi @ModernLifeIsWar first of all uhave you been diagnosed with ME?
I have not. I stumbled across these boards last month however and have found very helpful information from other members. I'm not sure what I'm experiencing but it seems a lot of people on these boards have a range of neurological issues and are very well educated on these subjects. That's the main reason I'm asking here is I have no idea where else to go and am hoping someone here has the knowledge to help me or lead me in the right direction. My Dr seems clueless and said she would get back to me so I'm just on my own right now trying to figure this out.
 

Kati

Patient in training
Messages
5,497
I have not. I stumbled across these boards last month however and have found very helpful information from other members. I'm not sure what I'm experiencing but it seems a lot of people on these boards have a range of neurological issues and are very well educated on these subjects. That's the main reason I'm asking here is I have no idea where else to go and am hoping someone here has the knowledge to help me or lead me in the right direction. My Dr seems clueless and said she would get back to me so I'm just on my own right now trying to figure this out.
The thing is we are only patients and we do not have a licence to practice medicine, and if wedid it would be inapppropriate to comment on a public forum not having access to the whole history, and a physical.

If your doctor is clueless and you have clearly abnomalities in your physical exam (tremors) and lab work (I can't see how high your creatinine is, the numbers are very fuzzy, and others with is clearly not regular test (aldolase- why was this test done) - since this doctor ordered these test it is fair that he needs to send you to someone else if he can't help you). At this point, consulting a neurologist for your tremors would be one priority, and the other one would be to double check the creatinine and trying to understand why it is high, and this may be due to many thing including what supplements or medication you are taking.
 
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I certainly see and appreciate what you're saying. I'm not looking for a diagnosis or anything but rather just trying to gain perspective from other people who have experienced similar issues or might know se potential causes for these abnormalities. I simply want to gain knowledge for my own personal research and I think sharing experience and knowledge is a great way to get on the proper track to solving mysterious health problems. I think that's the great thing about these boards is the ability to share knowledge, however I am fully aware the knowledge may not always be applicable to me. Nonetheless I feel it is a great way to learn and begin your own research which I think everyone should do as Dr's don't have all the answers.

Also my Dr was a neurologist and was pretty clueless to what was causing my symptoms hence the bloodwork. I have an appointment with another in 1.5 months but I'd rather try to figure out what is going on rather than sit idly till then.
 
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16
Also the creatinine was 1.5. This is always slightly elevated and I've seen very common among people who exercise with heavy weight training. I've had values around here for years.

My bigger concerns are simply what the cause of the iron deficiency and d3 could be. I eat lots of meat and take 5000 iu d3 daily. I simply want to hear from people who might have some knowledge here so I can know where to direct my research into this. I think being well informed is very important and I would like to know the most I can before my next Dr appointment.
 

Kati

Patient in training
Messages
5,497
What is your hemoglobin and hematocrit? Are you anemic? The thing with weight training is that it dammages muscles and RBC, and there is a constant need to repair and build new muscles, which requires iron. It may simply be physiologic and unrelated to your tremor problem.
 
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I suppose that could be though it seems very low especially for how much meat I consume. I would think I'd have normal levels at least. But I have no idea if it correlates to the tremors. Unfortunately my Dr did not test these but I had a test in march (shortly before this all set on) and they were normal. I will add that to my list of things to check on my next Dr appointment.

My thoughts are possibly low iron isn't allowing me to repair my muscles fast enough and that was what resulted in the excessive aldolase levels (albeit I have no noticeable atrophy or weakness). Just throwing ideas around to see what others think. I'm trying to piece together as much as I can about what might be going on at least. Also, not sure why my d3 is barely above normal when I supplement 5000 iu everyday. I also take magnesium. Once again possibly not related but maybe it is. Either way, I'm gonna try to get these levels up and see if my symptoms don't improve.
 

Sea

Senior Member
Messages
1,286
Location
NSW Australia
It would be useful if you could see a sports medicine doctor who would be familiar with interpreting your bloodwork in the framework of weight lifting.

I've seen anecdotal reports of people developing essential tremor with different combinations of low iron, low B12 and low vitamin D which resolved when they were treated for those deficiencies so you may have found your answers there. I would caution you to follow doctors' advice when supplementing, it will create other problems if you simply take huge amounts.

As to why you are deficient, there can be various reasons - your physical training, genetics or disease are all possibilities. How you respond to supplementation will give your doctors some clues where to look.

B12 deficiency cannot be entirely excluded by blood tests. Sometimes there are transport or absorption issues which are not reflected in a blood level. Sometimes it is a cofactor which is deficient which means the B12 can't be utilised even though there is plenty there.
 

Mij

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2,353
@ModernLifeIsWar

https://labtestsonline.org/understanding/analytes/mma/tab/test/

If MMA and homocysteine levels are increased and the vitamin B12 level is mildly decreased, then an early or mild B12 deficiency may be present. This may indicate a decrease in available B12 at the tissue level.

If only the homocysteine level is elevated and not MMA, then the person may have a folate deficiency. This distinction is important because giving folate to some who is B12-deficient will treat the anemia but does not treat the neurologic damage, which may be irreversible.

If both MMA and homocysteine levels are normal, then it is unlikely that there is a B12 deficiency.

A decreased level of MMA is not common and is not considered clinically significant.

I had breathlessness when my ferritin was below 20. I had low ferritin for over 20 years and took iron supplements daily. I didn't know why either because I ate red meat and liver cooked in cast iron pans and nothing helped except iron supplements.

My ferritin is up at 100 in the last year and these could be one or all the reasons:
1) I'm in menopause, (I never had heavy periods so I'm not sure this is the reason)
2) I take digestive enzymes with every meal
3) I started taking PepZin GI . . . a zinc supplement that may have healed my gut.
 

Jonathan Edwards

"Gibberish"
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5,256
Dear @ModernLifeIsWar,
It may be not so much that your doctor is clueless than they are being honest about not knowing what is causing your tremors. Most tremors we do not understand the cause of very much, although in general they can be categorised. I cannot see any test results there that would be relevant to tremors to be honest. (I am a physician and was for a while a neurologist.) The only condition that causes tremors that shows up on bloodwork that I can think of immediately is Wilson's disease with high copper (based on caeruloplasmin levels if I remember rightly).But your pattern of tremor does not sound like it.

As others have said you are likely to do better following doctors who are honest enough to say they do not know the answer than following people on the internet like us who are not qualified to advise, especially as this seems to have nothing to do with ME/CFS.